Barriers to Opioid Deprescription in Rural Newfoundland and Labrador: Findings from Pilot Interviews with Rural Family Physicians

MacLean, Cassandra and Heeley, Thomas and Versteeg, Everett and Asghari, Shabnam (2020) Barriers to Opioid Deprescription in Rural Newfoundland and Labrador: Findings from Pilot Interviews with Rural Family Physicians. Research Report. Memorial University of Newfoundland, St. John's, Newfoundland and Labrador. (Submitted)

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Abstract

Background: Medical doctors in Canada have a lack of education and understanding on how to safely prescribe opioids. Rural areas and Aboriginal populations have been identified as being at greater risk for opioid misuse. The purpose of this pilot project is to investigate barriers to rural physicians deprescribing opioids for noncancer pain in rural NL to better understand this under-researched topic. Methods: Semi-structured interviews were conducted over the phone and audio recorded. The audio recordings were transcribed using Microsoft Word then thematically analysed. The themes were discussed with another team member to reach a consensus. Results: Three broad themes were identified including system related, provider related and patient related barriers with sub-themes under each. Interpretation: These preliminary results identified many barriers including lack of resources in rural areas, lack of provider education and lack of patient understanding of the mechanisms of opioid prescriptions that fit into three broad categories. Barriers not previously identified in the literature were acknowledged including lack of pain management resources in rural communities as well as patient misunderstanding opioid medication pharmacology. These results are preliminary and further research is required.

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